Individual
CARISSA LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
558 E 2ND ST, POWELL, WY 82435-2001
(307) 754-2864
Mailing address
558 E 2ND ST, P.O. BOX 1191, POWELL, WY 82435-2001
(307) 754-2864
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
08/28/2012
Last updated
08/28/2012
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